This study is a cross sectional self-administered mailed survey to address the type and frequency of ethical dilemmas faced by physicians, how they approach them, the types of ethical support they would find useful in addressing these ethical dilemmas, and their attitudes and practices in situations of scarce resources. The questionnaire has been designed, piloted, translated and back translated. The study sample will include 400 general practitioners and general internists from each of four European countries including England, Switzerland, Norway and Italy. IRB approval has been attained at the NIH and in each of the participating countries. A survey firm has been selected and data collection is in planned to begin at the end of 2002.